Volume of ventricular blood is an important determinant of outcome in supratentorial intracerebral hemorrhage

Objective: To determine the prognostic significance and pathophysiologic im plication of intraventricular extension of supratentorial intracerebral hem orrhage. Design: Prospective study. Setting: Acute stroke and neurointensive care units of a tertiary care hosp ital. Patients: One hundred twenty-nine patients with supratentorial intracerebra l hemorrhage, managed medically, Interventions: Two patients had intraventricular catheters placed for exter nal drainage. No patient received thrombolytics or surgical evacuation of c lot, Measurements and Main Results: Of the 129 patients, 47 had intraventricular extension of their hemorrhages, These patients had larger intraparenchymal hemorrhages (36.6 cm(3) vs, 15.0 cm3) and lower initial Glasgow Coma Scale scores (mean, 9.6 vs, 13.7), Their 30-day mortality rate was 43% compared with only 9% among those without ventricular extension, Univariate and mult ivariate logistic regression modeling was used to assess the prognostic sig nificance of various measures of intraventricular hemorrhage, The presence of intraventricular hemorrhage, the number of ventricles containing blood, fourth ventricular blood, and intraventricular hemorrhage volume were each related to 30-day mortality in a univariate analysis, but only intraventric ular hemorrhage volume contributed significantly to outcome prediction in t he presence of Glasgow Coma Scale score, Conclusions: Volume of intraventricular hemorrhage is an important determin ant of outcome in supratentorial intracerebral hemorrhage.